As activity tracking goes mainstream, an arsenal of consumer technology is rolling out for sleep. But how much do these interventions help?
At 2.16am, I stumble to the bathroom. I catch a glimpse of myself. The light from the red bulb is flattering – I’ve been told to eliminate all blue light on my nocturnal trek – but the sleep-tracker headband, currently emitting the sound of gently lapping waves, kills any woke-up-like-this vibe. I adjust its double straps and feel my way back to bed.
The next time I wake is at 6.30am – after fractured dreams in which the Dreem 2 headband makes many cameos – to birdsong, also from the headband. When I check the app, I see I have slept six-and-a-half hours of my anticipated eight. Anxious to remedy this, I head out for my first coffee. In his new book Blueprint: Build a Bulletproof Body for Extreme Adventure in 365 Days, athlete Ross Edgley warns that this sort of overriding behaviour can bring about “biochemical bankruptcy”. Not now, Ross.
Health influencers like Edgley are all over sleep lately, and no wonder, when so many of us obsess over it. A 2021 report released by the Sleep Health Foundation estimates around one in 10 Australians have a sleep disorder, while a report from 2019 found that more than half are suffering from at least one chronic sleep symptom. Studies have suggested that sleep deficiency can lead to weight gain and a weakened immune system and that poor sleep patterns may contribute to later dementia risk.
In recent years, sleep-fretting has intersected with fitness-tracking, with the latest bio-hacks regularly featured on the podcasts of personal-development heavyweights such as Joe Rogan, whose Whoop Strap – worn around the wrist – told him he was getting four or five hours a night, not the seven or eight he’d thought; and Aubrey Marcus, whose Oura ring measures various biomarkers overnight and gives him a total score in the morning. “If I can get close to 80%, I’m golden for the day,” Marcus told the authors of My Morning Routine.
Wearables, such as watches, rings and headbands, appeal to those of us who enjoy geeking out on our stats, but could they also be cultivating anxiety and feeding into insomnia? Associate Prof Darren Mansfield, a sleep disorders and respiratory physician who is also deputy chair of the Sleep Health Foundation, thinks some balance is needed.
“These devices in general can be a good thing,” he says. “They’re not as accurate as a laboratory-based sleep study, but they are progressing in that direction, and technology enables the person to be engaged in their health. Where it can become problematic is people can become a bit enslaved by the data, which can lead to anxiety or rumination over the results and significance. That might escalate any problems, or even start creating problems.”
As a clinician, Mansfield thinks that the most useful role of these devices is monitoring routine, not obsessing over the hours of good-quality sleep. “There will be some error margin, but nonetheless when we’re looking for diagnostic information, like timing of sleep and duration of sleep, they can capture that,” he says.
Since Mansfield admits his sleep doesn’t need much hacking, I seek out an insomniac-turned-human guinea pig. Mike Toner runs the dance music agency Thick as Thieves, and has been on a mission for five years to fix the sleep issues earned from a decade of late nights in Melbourne clubs and reaching for his phone to answer international emails at 3am.
“I tried everything,” he says. “Magnesium capsules and spray, melatonin and herbal sleep aids. I even signed up for treatment at a sleep centre. You sleep in this room with all these wires connected to you, things coming out of your nose, cameras trained on you. Ironically, I slept better that night than I have any other night.”
He decided to start monitoring his body in earnest, learning about the latest devices from the Huberman Lab Podcast and The Quantified Scientist. Sleep-monitoring wearables have progressed from having an accelerometer to track movements which are fed through an algorithm to predict when a person is asleep, to being able to track sleep latency; sleep efficacy; heart-rate variability; light, deep and REM sleep and sleeping positions.
Toner’s accumulated a few as the technology becomes more sophisticated. He estimates having spent around $1,500 on them, and a further $3,500 for the sleep-centre treatment.
Then there are the cooling devices. Toner beds down on a Chilipad as soon as the weather gets warmer – a hydro-powered cooling mattress.
The idea is that lying down in a cool room – perhaps after taking a warm shower – tricks the body into slumber, since our body temperature drops when we’re asleep.
Non-techy strategies include having hands and feet out from under the covers, or using a fan. Lifestyle guru and entrepreneur Tim Ferriss recommends a short ice bath before bed. Be warned, though: Dave Asprey – founder of Bulletproof, which sells high-performance products – once tried putting ice packs on his body right before bed. As he told MensHealth.com: “I ended up getting ice burns on about 15% of my body.”
Mansfield says that ensuring you’re cooler in the evenings may help with sleep. “Generally, a lower-level temperature is better tolerated at night … 25C can make a beautiful, comfortable day, but can be unbearably hot at night when our own core temperature drops, so 18C or 19C is more tolerable.
“Then in the last two hours before getting up, your temperature rises again – you might have thrown off the blanket in the night and then might wake up at 5am feeling freezing cold.”
And what about the new frontiers of technology? According to neuroscientist Matthew Walker, in his influential book Why We Sleep, in the future, we can expect the marriage of tracking devices with in-home networked devices such as thermostats and lighting.
“Using common machine-learning algorithms applied over time, we should be able to intelligently teach the home thermostat what the thermal sweet spot is of each occupant in each bedroom, based on the biophysiology calculated by their sleep-tracking device,” Walker says. “Better still, we could program a natural circadian lull and rise in temperature across the night that is in harmony with each body’s expectations.”
Mansfield thinks this kind of integration is feasible, and that a thermostat linked to a device measuring circadian rhythms offers plausible benefits in preparing people’s sleep, but he predicts that automated control of room lighting will wind up being manually overridden, because technology can’t necessarily gauge when we’re in the middle of reading a book or having a conversation. “It’s liable to just irritate people,” he says. He’s more interested in technology that will track conditions like sleep apnoea.
As Toner has concluded, no device is a silver bullet. Ultimately, it was a $70 online cognitive behavioural therapy (CBT) course that his GP referred him to that fixed his sleep over three months of strict adherence. Now he just uses technology to make sure he’s not drifting off track.
The key lessons? Only use your bedroom for sleep and sex. Set your alarm for the same time, no matter how late you get to bed. Screens off early. No day-napping. Alcohol is a bad idea. All of these things are easily monitored yourself using a good old notebook, and they don’t cost a cent. They just take persistence.
With those good habits in place, Toner is now mindful of how he will put the CBT pointers he’s learned during lockdowns into practice once his life picks up its pace again.
“I used to put this obligation on myself to be there all the time with my artists, but interestingly, coming out of this pandemic, a lot of the artists are having the same train of thought as I am, wanting to avoid late nights,” Toner says.
He’s even coaching some of them for a charity run – quite the lifestyle change for many. “I’ve spent so long fixing this that one of the things I’ve realized, when we eventually go back to work routines, is I’m going to be fiercely protective of my sleep.
Winter wellness during Covid-19 will require much more than the usual health tips we hear each year. As infectious disease experts advise us to continue hunkering down to prevent a spike in cases, we’ll have to take extra steps to physically and mentally deal with the colder and darker days ahead.
“Now is the time to take a functional and holistic approach to healthcare,” says Dr. Robin Berzin, the founder and CEO of holistic medical startup Parsley Health and a graduate of Columbia University’s College of Physicians and Surgeons. The serial healthcare entrepreneur built the health-tech platform to focus on whole-body, transformative medicine.
“We look at the body very differently,” says the Brooklyn-based mother of two. “For instance, when I look at the gut, I also focus on energy, mood, anxiety and sleep patterns. Most doctors don’t look at you this way because the healthcare system is developed in a way that’s very fragmented. We miss the big picture, even at top institutions.”
1. Shift your sleep cycle earlier by one hour. “One of the biggest reasons I see people tossing, turning, and not feeling rested the next day, is going to bed too late,” says Dr. Berzin.
Inadequate sleep increases the accumulation of toxic metabolic debris in the brain, and creates stress in the body. The cortisol levels all lead to a less than lovely mix of increasing appetite, weight gain, and fatigue, as well as suppressing immune function.
“Winter is one of the best times to start the habit of going to bed earlier. Early to bed avoids the late evening cortisol bump. Some people call this a ‘second wind’ but the truth is it can lead to an uneven sleep cycle. I know that when I go to bed by 10pm instead of 11pm, I sleep deeper and feel more rested in the morning. This is especially true as a mom with early waking kids!”
According to Berzin, an optimal sleep schedule would be from about 10 PM to 6 AM daily because it is in line with the body’s natural circadian rhythm and the general rising/setting of the sun.2. Make magnesium a staple. It’s the most common mineral deficiency in America. But magnesium is essential because it supports these y-shaped proteins produced by your immune system that neutralize harmful bacteria and viruses. From a burnout/stress perspective, magnesium helps to calm the nervous system, mildly lower blood pressure, and quickly relax smooth muscle throughout the body. “I often joke that magnesium is nature’s Xanax,” says Dr. Berzin. “I’ve been taking it regularly and recommend it to my patients when they had trouble sleeping or with anxiety. It’s not addictive and you can take 200mg to 400mg at bedtime. It’s especially good for pregnant moms who can’t take other sleep aids.”
3. Learn a simple breathing practice to stay calm, focused and energized. Meditation is not just for yogis. From an immune perspective, numerous studies have proven that meditation increases the production of antibodies.
Mindfulness-based practices have been shown to dampen the activity of genes associated with inflammation—and even reduce the molecular damage caused by stress/burnout. Specifically, deep belly breathing during meditation stimulates the vagus nerve and turns on the ‘rest and digest’ part of our nervous system to lower heart rate and reduce anxiety.
“I used to teach both yoga and meditation,” says Dr. Berzin. “Meditation is one of the ways I support myself to manage both mom life and building a venture-backed startup.” Her favorite breathing practice is to inhale for five seconds, exhale for seven, which stimulates the nervous system to heal. It’s incredibly effective.
Says Berzin, “Meditation is not a quick fix but, over time, regularly deactivating your body’s stress response may support stronger immune function and reduce burnout.”
4. Drink alcohol no more than 3 days per week. During the pandemic, doctors noted a spike in the alcohol intake of patients due to stress, anxiety and the new ways that weekdays and weekends have seemed to blend. But in addition to being addictive, alcohol is a depressant and interrupts quality sleep. “I find that most people do best with having at least 3-4 nights a week completely off from alcohol,” she says. “This can be the difference between a clear head and brain fog.”
If imbibing, opt for higher quality, lower sugar varieties of alcohol such as tequila, mezcal, or vodka with seltzer and a citrus wedge and steer clear of beer and sugary cocktails. “On my ‘on-nights’ I tend to enjoy a glass of natural wine or a mezcal margarita which allows alcohol to have a balanced, small place in my routine, not a big role,” says Berzin. 5. Take Vitamin D3/K2. If you spend the majority of your day inside, as many of us do these days, you may be deficient in Vitamin D (like 42% of the US population), which is essential for the effective activation of our immune defenses. Berzin explains that Vitamin D3/K2 is the best formulation to absorb and activate Vitamin D.
When combined with Vitamin K2, Vitamin D3 forms your best defense against infections, osteoporosis, dementia, and type 2 diabetes. Most people are deficient and new research is showing that Vitamin D3 plays a critical role in our defenses versus Covid-19. Studies show that adding just 1,000 IU of Vitamin D per day can reduce fatigue, mood swings, joint pain, muscle cramps, depression, and anxiety.
Says Dr. Berzin: “I take 5000 units daily and give at least 1000units to my toddler every day and my infant every other day. It’s especially important for pregnant moms as research show it has implications for kids’ bone and dental health if deficient in utero.”
6. Exercise is nature’s antidote to seasonal affective disorder (SAD). SAD is common in northern climates and winter months. To combat it, Dr. Berzin prescribes regular exercise. It improves immune regulation and mental health by helping the brain cope with stress.
“For some of my patients SAD is massively disruptive. For others it’s mild but palpable,” says Berzin. “While you can’t always cure it with exercise… it can be the difference between a manageable winter and one that’s off the rails.”
Aim for at least 150 minutes of moderate aerobics or 75 minutes of vigorous aerobic activity a week, or a combo of both. Weight training and resistance work are also essential.
7. Drop the fear of (good) fat. Omega-3 fatty acids reduce inflammation, and with it, chronic disease. However, we have much more of the inflammatory type called Omega-6, as the standard American diet is large on inflammatory oils and oxidized fats in processed and packaged foods.
“We home make baby food and even sometimes baby formula for our infant,” says the mother of two. “The food is a blend of wild salmon, winter squashes, Brussels sprouts, apples, and EVOO; all are the best sources of Omega-3s. It’s cheaper and healthier than the packets. I even add EVOO or cod liver oil to my kids’ bottles.”
She breaks down the science of taking in the right fats: the ratio of Omega-3 to Omega-6 fatty acids that you consume is actually more important than the amount of either. The optimal ratio is 4:1, with ideally four times more Omega-3 fatty acids to counteract Omega-6’s inflammatory properties
Swap out foods rich in Omega-6 (processed foods and industrialized seed oils such as corn, soy, canola, and sunflower oils) and opt for more anti-inflammatory Omega-3 rich-foods (walnuts, chia seeds, wild salmon, sardines, anchovies, pasture-raised eggs, and flax seeds.)
8. Feed the good bugs. Add probiotics and prebiotics to support your healthy microbiome, the ecosystem in your gastrointestinal tract that helps regulate your immune system. It is home to 40 trillion microbes—the vast majority of which are essential for optimal health.
What lives and dies in the gut is a matter of what you eat daily, says Berzin. Whole veggies, unprocessed foods and fiber feed the best bugs in the gut for a healthy immunity, and even better mood.
For best practices, eat more fermented foods and prebiotics (what your microbes feast on). Fermented foods include kimchi, kombucha, sauerkraut, yogurt and prebiotic fibrous foods like garlic, onions, leeks, artichokes, asparagus and onions, among others.
9. Eliminate refined sugar and carbs from your diet. Eating too much sugar can decrease your immune fighter (white blood) cells, making you more susceptible to illness and infection. Also, too much refined sugar can overfeed the “bad” bacteria in your gut microbiome.
From a burnout/stress perspective, your body absorbs simple sugars quickly, which increases your blood sugar and gives you a temporary surge of energy. But this “sugar high” is short-lived and followed by a dramatic crash in energy, often accompanied by irritability, sadness, or mental fogginess.
“The idea isn’t to deprive your self,” says Berzin. “It’s about ensuring you’re getting your daily requirement of carbohydrates and sugars from whole food-based sources such as fresh fruit, starchy vegetables, and whole grains rather than processed foods like bagels, pizza, cookies, and on-the-go “nutrition” bars.” Need a healthy detox? Eliminate refined sugar from your diet for five days straight.
10. Connect responsibly. In these times it’s critical to find ways to be socially close while being physically safe. Connecting through screens is exhausting and after a while, alienating. Now is the time to take socially distant walks with friends, find outdoor exercise opportunities, and meet for a masked chat on the outdoor patio.
“We will have to live with this virus in our lives and even with the vaccine, it may be like the flu where it doesn’t entirely go away,” says Berzin. “That means learning to live vibrantly while taking precautions and protecting the most vulnerable.”
She says there are so many ways to be mindful: testing, wearing masks, handwashing, and “podding” up with closest friends and family to create a safe bubble and connect responsibly.
I am a Lifestyle Reporter for Forbes, covering the business of beauty and style, as well as the arts, luxury real estate and more. I’m a former television reporter for NY1 News, where I covered all things Queens, NY and got my start in business news as a greenroom greeter and PA at Fox Business. I am a graduate of Columbia Journalism School and an adjunct professor at the NYU Arthur L. Carter Journalism Institute. Twitter @TanyaKlich
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Rejecting the advice of its scientific advisers, the federal government has released new dietary recommendations that sound a familiar nutritional refrain, advising Americans to “make every bite count” but dismissing experts’ specific recommendations to set new low targets for consumption of sugar and alcoholic beverages.
The “Dietary Guidelines for Americans” are updated every five years, and the latest iteration arrived on Tuesday, 10 months into a pandemic that has posed a historic health threat to Americans. Confined to their homes, even many of those who have dodged the coronavirus itself are drinking more and gaining weight, a phenomenon often called “quarantine 15.”
The dietary guidelines have an impact on Americans’ eating habits, influencing food stamp policies and school lunch menus and indirectly affecting how food manufacturers formulate their products.
But the latest guidelines do not address the current pandemic nor, critics said, new scientific consensus about the need to adopt dietary patterns that reduce food insecurity and chronic diseases. Climate change does not figure in the advice, which does not address sustainability or greenhouse gas emissions, both intimately tied to modern food production.
A report issued by a scientific advisory committee last summer had recommended that the guidelines encourage Americans to make drastic cuts in their consumption of sugars added to drinks and foods to 6 percent of daily calories, from the currently recommended 10 percent.
Evidence suggests that added sugars, particularly those in sweetened beverages, may contribute to obesity and weight gain, which are linked to higher rates of chronic health conditions like heart disease and Type 2 diabetes, the scientific panel noted.
More than two-thirds of American adults are overweight or obese; obesity, diabetes and other related conditions also increase the risk of developing severe Covid-19 illness.
The scientific advisory group also called for limiting daily alcohol consumption to one drink a day for both men and women, citing a growing body of evidence that consuming higher amounts of alcohol is associated with an increased risk of death, compared with drinking lower amounts.
The new guidelines acknowledge that added sugars are nutritionally empty calories that can add extra pounds, and concede that emerging evidence links alcohol to certain cancers and some forms of cardiovascular disease — a retreat from the once popular notion that moderate drinking is beneficial to health.
But officials at the Department of Agriculture and the Department of Health and Human Services rejected explicit caps on sugar and alcohol consumption.
Although “the preponderance of evidence supports limiting intakes of added sugars and alcoholic beverages to promote health and prevent disease,” the report said, “the evidence reviewed since the 2015-2020 edition does not substantiate quantitative changes at this time.”
The new guidelines concede that scientific research “suggests that even drinking within the recommended limits may increase the overall risk of death,” and that alcohol has been found to increase the risk for some cancers even at low levels of consumption.
But the recommendation from five years ago — one drink per day for women and two for men — remains in place.
The new guidelines do clarify, for the first time, that the limits apply to those days when alcohol is consumed. The vagueness of the previous recommendations left suggested to many American men that they could binge-drink a couple of days a week, so long as they did not exceed 14 drinks over the course of a week.
Dr. Timothy Naimi, a member of the dietary guidelines advisory committee, said the guidelines “reaffirm two important but overlooked health messages”: that alcohol is “a dangerous substance” and that drinking less is better than drinking more at all levels of consumption.
“This is especially a key point in the time of Covid and holidays, in which consumption has increased and important alcohol control policies have been relaxed,” such as restrictions on home delivery, Dr. Naimi said.
The main sources of added sugars in the American diet are sweetened beverages — including sodas, as well as sweetened coffees and teas — desserts, snacks, candy, and breakfast cereals and bars. Most Americans exceed even the 10 percent benchmark; sugars make up 13 percent of daily calories, on average.
The new guidelines do say for the first time that children under 2 should avoid consuming any added sugars, which are found in many cereals and beverages.
Critics were disappointed that the federal agencies had ignored the recommendations of the scientific advisory committee.
“I’m stunned by the whole thing,” said Marion Nestle, a professor emerita of nutrition and food studies at New York University and author of several books on the government’s dietary guidelines.
“Despite repeated claims that the guidelines are science-based, the Trump agencies ignored the recommendation of the scientific committee they had appointed, and instead reverted to the recommendation of the previous guidelines,” she said.
The composition of the dietary advisory committees drew controversy earlier this year, because many of the experts had ties to the beef and dairy industries. Yet the scientists went further in their advice than had previous committees, particularly with the recommendations to limit sugar and alcohol, Dr. Nestle said.
“Those were big changes, and they got all the attention when the report came out last summer for very good reasons — and they were ignored in the final report,” Dr. Nestle said.
“The report was introduced as science-based — they used the word ‘science’ many times, and made a big point about it,” she added. “But they ignored the scientific committee which they appointed, which I thought was astounding.”
In other ways, the new guidelines are consistent with previously issued federal recommendations. Americans are encouraged to eat more healthy foods, like vegetables, fruits, legumes, whole grains, nuts, seafood, low-fat or nonfat dairy, and lean meat and poultry.
The guidelines urge the nation to consume less saturated fat, sodium and alcohol, and to limit calorie intake.
Indeed, officials with the Center for Science in the Public Interest, an advocacy organization, said they were pleased the guidelines continued to affirm a diet rich in fruits and vegetables and lower in red meat and processed meats, though they said it “misses the mark” on added sugars.
Jessi Silverman, a registered dietitian and public health advocacy fellow at C.S.P.I., called on the incoming Biden administration to take action to remove barriers to healthy eating, such as restoring nutritional standards for whole grains, sodium and milk in the national school lunch program, which were rolled back under President Trump.
For the first time, the guidelines take a “full life-span approach,” trying to sketch out broad advice for pregnant and breastfeeding adults and for children under 2.
One of the recommendations for pregnant women, those about to become pregnant and those who are breastfeeding is to eat ample seafood and fish that is rich in omega-3 fatty acids but low in methylmercury content, which can have harmful effects on a developing fetus. This dietary pattern has been linked to healthier pregnancies and better cognitive development in children.
The new guidelines emphasize the health benefits of breastfeeding, which has been linked to lower risks of obesity, Type 1 diabetes and asthma in children. Foods that are potential allergens, like eggs and peanuts, should be introduced during the first year of life — after 4 months of age — to reduce the risk of developing allergies.